E-Mail Health Alerts Spread Help and Hoaxes

Forwarded by a well-meaning friend, it claimed tampons contain asbestos and dioxin, toxins that may cause cancer, birth defects and reproductive problems.

"I’ve always suspected there were pollutants in tampons and this made me decide to stop using them," says Zimmerman, a yoga instructor in New York City. "I want the people I care about to be safe, so I sent that e-mail to every woman I know."

Rich Buhler, the creator of TruthOrFiction.com, an Orange, Calif., Web site that investigates Internet hoaxes, wishes women such as Zimmerman had instead deleted the message.

"The e-rumor about toxins in tampons has no basis in reality," he says. "Nevertheless, it continues circulating and spreading unnecessary panic."

According to the Washington-based Pew Internet and American Life Project, 80 percent of Internet users–a growing number of them women–get medical information and advice from the Web.

"Women are more likely than men to forward health warnings and other e-mails they receive as a way of strengthening their social network," says Susannah Fox, Pew’s associate director. "As caregivers, they are also more likely to seek out health information for people they hope to help."

Some health advocates and Internet experts say that as women’s reliance on Web-based health information grows, so too does their interest in mass e-mails, which are sometimes helpful but are also often misleading.

Widespread Warnings

The e-mail health alerts that women circulate warn against everything from herpes to the hantavirus. They are derived from news reports, friends’ personal experiences, old wives’ tales and urban legends. Some are copied directly from reputable Web sites, written by concerned consumers or concocted by e-pranksters.

Most e-mail health alerts share the same ingredient: appealing to readers’ concerns about health issues and to their sense of personal empowerment.

Take a popular e-mail about inflammatory breast cancer that has been circulating since last spring.

Inspired by a May 2006 Seattle news broadcast on inflammatory breast cancer, it says that the disease is rare but also warns women that it is difficult to detect and deadly.

The facts in the e-mail check out.

Inflammatory breast cancer afflicts less than 5 percent of women with breast cancer. It is marked by swelling and redness that may be mistaken for an infection, but which are actually caused by fluid drainage pipes in the breast getting clogged by cancer cells. Because its symptoms are misleading and because it may be difficult to detect on a mammogram, it is often not identified until the cancer is advanced and difficult to treat.

"When I read the e-mail about inflammatory breast cancer and the news reports to which it provided Web links, the fact that this was so deadly yet so simple to recognize really struck me," says Shamaya Gilo, a New York philanthropist who forwarded the e-mail to 50 women. "I sent it to my friends and family so they could save themselves if they spotted the symptoms. I also forwarded it because I’m fed up with this culture in which health is treated as a spectator sport. People shouldn’t sit on the sidelines and wait for their doctor to make them better. They need to be more engaged in their own health."

Experts say the warning about inflammatory breast cancer has all the ingredients of a successful e-alert.

‘Wow’ Stories That Catch Attention

"These are ‘wow’ stories that catch our attention," says Buhler. "They have grassroots appeal because they concern issues that don’t make top headlines. And when we receive them, we want to be safe and pass them along just in case they turn out to be true."

The ease of receiving and forwarding these e-mails also boosts their popularity.

"Doctors are only available during office hours, and even then, they tend to be rushed," says Fox. "But Internet health information is always available and easy to pass along. It can help you learn about something like inflammatory breast cancer even if your doctor never broaches the topic."

Health advocates say that while e-mail health alerts such as the one about inflammatory breast cancer can help educate women about their health, others are spreading trouble each time a reader clicks "send."

Many of these e-mails are hoaxes, such as ones claiming sunscreen makes children go blind, bananas are infested with flesh-eating bacteria, and women are dying after smelling poisoned perfume samples that they receive in the mail.

Others may be well-intentioned and appear reliable, but are in fact misleading.

Take the e-alert about E. coli bacteria lurking in Dole-brand salad mix. Stemming from an October 2005 incident in which several Minneapolis residents got food poisoning, it conveys the impression that all Dole salad mix is tainted, when in fact this was an isolated incident and has long since been remedied.

Take a more widespread health alert claiming antiperspirant is the leading cause of breast cancer. Well-written, it cites pseudo-science: "Antiperspirant, as the name clearly indicates, prevents you from perspiring, thereby inhibiting the body from purging toxins from below the armpits. These toxins do not just magically disappear. Instead, the body deposits them in the lymph nodes below the arms since it cannot sweat them out. This causes a high concentration of toxins and leads to cell mutations: a.k.a. CANCER."

With its alarming language, this e-mail has upset–and fooled–so many readers that it has prompted the Atlanta-based American Cancer Society to issue an advisory about the lack of scientific evidence behind it and studies that refute it.

Sorting Fact from Fiction

In response to the surge in e-mail health warnings, medical organizations are doing their best to help consumers sort fact from fiction.

The Centers for Disease Control and Prevention, for instance, maintains a Web site where it debunks health rumors about everything from contaminated Coca-Cola to HIV-infected needles placed on gas pump handles.

"We try, but there’s no way we can catch them all," says Sharon Hoskins, a CDC spokesperson. "There are so many e-mail hoaxes that it’s all we can do to address the ones that attribute false information to our name."

Because health authorities can’t stop e-rumors–and because these rumors are spread by individuals–experts say Web users need to stay on guard.

"Before you forward an e-mail health alert, check its source and content to make sure you’re not spreading junk," says Pam Fielding, president of E-Advocates, a Washington-based Internet consulting group.

For fact-checking purposes, there are rumor-sleuthing sites such as TruthOrFiction.com and Snopes.com and reputable health sites such as MayoClinic.com and WebMd.com.

"Always check e-mail health warnings with more than one source," says Suzanne Dickerson, an associate professor of nursing at the State University of New York at Buffalo. "And if possible, check with your physician too."

Health advocates say the best way to get legitimate medical information via e-mail is to join the e-mail subscription lists of issue-specific organizations such as the American Cancer Society (www.cancer.org), the American Heart Association (www.heart.org) and NARAL Pro-Choice America (www.naral.org).

"All of these organizations send e-mails to consumers," says Buhler. "And none of them is likely to warn against flesh-eating bananas."

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